Q: What are the side effects of Ritalin on a 5-year-old boy? Are there any long-term problems associated with it?
Dr. Jensen: Side effects for 5-year-olds are pretty much the same as for 15- and 25-year-olds. They include headaches, stomachaches (particularly if taken without food), loss of appetite, difficulty sleeping, and sometimes irritability. Long-terms effects of Ritalin have been studied by following children over time who have been on medication. These studies do not indicate any significant adverse effects, other than failure to gain weight.
Q: My daughter (7 years old) has recently been diagnosed with ADD. I'm strongly opposed to her going on medication. What are some of the other options for her? Have they been proven to be as successful as Ritalin?
Dr. Jensen: The other major proven treatment is what is called behavior therapy. It is a specialized form of training for parent or teacher, or both, that gives them guidance setting up reward and consequence programs for children. This is not your normal psychotherapy. It's important to ensure that the child's therapist is expertly trained in behavior therapy. Behavior therapy is not as effective as medication, on average, but one-third of children will do very well with this treatment. All will get at least some benefit.
Q: My fifth grade son has been on Ritalin now for 2 years and is greatly improved. How do you know when your child is ready to go off medication? Will they automatically relapse?
Dr. Jensen: It is often a good idea to try the child off medication shortly after the beginning of the school year, after the child has had time to adjust to the new classroom. Many children find over time that they do not need to continue taking medication, as they are better able to control the symptoms themselves. This does take time, however, and not every child is able to go off medication. If a child has an extraordinary teacher or very small classroom environment, it is possible that that child may be able to go off medication when they are in those optimal surroundings. This will vary from child to child, however.